Surgical procedures and, in particular, neuro-related procedures are often assisted by a surgical navigational system to assist a surgeon in translating and positioning a surgical tool or probe. Conventional surgical navigational systems use reflectors and/or markers to provide positional information of the surgical tool relative to a preoperative rendering of a patient anatomy. Surgical navigational systems, however, do not carry out neuromonitoring functions to determine the integrity of a neural structure or the proximity of the surgical tool to that neural structure. On the other hand, neural integrity monitoring systems are designed to use electrostimulation to identify nerve location for predicting and preventing neurological injury. However, neural integrity monitoring systems do not provide visual navigational assistance. Therefore, there is a need for an integrated neuromonitoring and surgical navigational system that is capable of visually assisting a surgeon in navigating a surgical tool or probe as well as being capable of neuromonitoring to evaluate surgical tool proximity to a neural structure and/or the integrity of the neural structure.
In one aspect, this disclosure is directed to an apparatus having an intraoperative neurological monitoring system designed to provide real-time neurological information regarding a neural structure of a patient. The apparatus further includes a surgical navigational system communicatively linked with the neurological monitoring system and designed to provide a geographical representation of the neural structure.
In another aspect, this disclosure is directed a method of guiding a neural surgical procedure. The method includes applying electrostimulation to a neural structure of a patient and determining a response to the electrostimulation by the neural structure. The method further includes determining positional information of the neural structure from the response and displaying a geographical representation of the neural structure from the positional information of the neural structure on a graphical user interface (GUI).
According to another aspect, this disclosure is directed to a surgical method that involves applying a stimulus to a neural structure and visually determining a position of the neural structure from visual inspection of a GUI showing a geographical position of the stimulated neural structure.
In yet another aspect, this disclosure is directed to a method including the displaying of a preoperative visualization of patient anatomy and tracking placement of an instrument in the patient. The method further involves application of a stimulus to an anatomical feature of the patient and the determination of a response of the anatomical feature to the stimulus. The method also includes modifying the preoperative visualization to vary a visualization of the anatomical feature based on the response of the anatomical feature to the stimulus.
These and other aspects, forms, objects, features, and benefits of the present invention will become apparent from the following detailed drawings and descriptions.
FIG. 1 is a pictorial view of an integrated surgical navigational and neuromonitoring system.
FIG. 2 is a pictorial view of a surgical suite incorporating the integrated surgical navigational and neuromonitoring system of FIG. 1.
FIG. 3 is a block diagram of the integrated surgical navigational and neuromonitoring system of FIG. 1.
FIG. 4 is a front view of a GUI displayed by the integrated surgical navigational and neuromonitoring system of FIGS. 1-3.
FIG. 5 is a front view of a portion of the GUI shown in FIG. 4.
FIG. 6 is a block diagram of a wireless instrument tracking system for use with the integrated surgical navigational and neuromonitoring system of FIGS. 1-3.
FIG. 7 is a side view of surgical probe according to one aspect of the present disclosure.
FIG. 8 is a side view of a cordless retractor capable of applying electrostimulation according to one aspect of the present disclosure.
FIG. 9 is a side view of a corded retractor capable of applying electrostimulation according to one aspect of the present disclosure.
FIG. 10 is a side view of a cordless bone screwdriver capable of applying electrostimulation according to one aspect of the present disclosure.
FIG. 11 is a side view of a surgical tap capable of applying electrostimulation according to another aspect of the present disclosure.
